Our Gender Identity Development Service

4 November 2018

As reported in the Observer today, the Trust is currently
conducting an internal review into issues raised about the Gender Identity Development
Service (GIDS).

The first thing to say is that GIDS has a long track record of thoughtful
and high quality care in supporting young people presenting with symptoms of
gender dysphoria. This is borne out by independent CQC inspections, as well as
the feedback we receive from young people themselves and their families through
our Experience of Service Questionnaire (ESQ).

All
staff in the service are aware of the review and have been encouraged by both
our Medical Director and Chief Executive to avail themselves of this
opportunity to express their own views about the service. The Trust is concerned
by the tone and manner in which allegations have been made. They reveal a
negative attitude to gender dysphoria and gender identity which does not
reflect the views or the approach of the Trust or GIDS.

In parallel, similar concerns
have also been raised by a group of parents who have shared these with The
Observer. They are concerned that the pressure on the service from rising
referrals is leading to a fast-tracking of patients and a lack of regard for
what they are calling rapid onset gender dysphoria. We recently published our
view of the term and the phenomenon it refers to on our GIDS website.

The GIDS was founded in 1989 and is one of the longest standing services
for gender diverse children and young people in the world. Domenico Di Ceglie,
who founded the service, wrote a set of therapeutic aims which we still abide
by today. This includes the unconditional acceptance and respect for young
people’s gender identity. We do not therefore take a view regarding the outcome
of an individual’s gender identity development: rather, our focus is to
provide a space for exploration of gender, to ameliorate any negative impacts
on general development and to work with young people to think through all the
options open to them. These principles remain central to the delivery of the
service.

A
comprehensive psychosocial assessment precedes any referral to the endocrine
clinic for consideration of physical treatments. Whilst it is the case that
most young people attending the service have a wish to pursue physical
interventions, 59% of those attending under 15 chose not to pursue an endocrine
clinic referral.

We
recognise that there are strongly held views among patients and families and
their representatives including those who wish for physical treatment to be
offered earlier or by those who feel that physical treatments should not be
offered to young people at all. The service has worked hard, and
continues to do so, to maintain a balanced view in which we are fully aware of
wider social, cultural, legal and political factors, but maintain a focus on an
individual approach to care informed by the particular circumstances of each
young person we see.

We
do not limit or curtail assessments because of pressure to move swiftly to
medical interventions. With complex cases, rather than truncating assessments,
we will often extend the time given to trying understand what may be going on.
Whilst the national specifications against which the service is commissioned
describe an assessment phase of between 4 and 6 meetings, one outcome of
assessment may be further assessment. Nevertheless, we are always mindful that
gender dysphoria is not in and of itself a mental health diagnosis. The young people seeking support from
our service frequently experience high levels of distress, victimisation and
isolation related to their self-identified gender. We are committed to ensuring
we work to recognise and meet the various needs of all the young people we see
in this complex and contentious field.

We
hope any families reading today’s news will feel reassured that their children
will be cared for respectfully, comprehensively and mindfully. As a Trust and
as a service, we are very alive to the current debates raging publicly about
the care of gender diverse children and young people and we aspire to remain a
safe place for children, young people and their families to come to to explore
their feelings around their gender with the wholehearted support of a dedicated
multi-disciplinary team of experts in this highly specialised field.